Mechanism and Pathophysiology of Bleeding from Esophagogastric Varices
Bleeding from ruptured esophagogastric varices is the main complication of portal hypertension and a major cause of death. The risk factors of variceal bleeding have been reported but are still debated. Variceal hemorrhage can be caused by various factors including topical, portal hemodynamic, and systemic factors.
A hepatic vein pressure gradient (HVPG) of 10–12 mmHg is required for the development of varices. Furthermore, an HVPG > 12 mmHg is necessary for the occurrence of variceal hemorrhage. Factors that further increase variceal wall tension causing it to reach a threshold and develop a topical mucosal disorder of varices may induce variceal hemorrhage. Considering these factors, management of esophagogastric varices must be performed.
KeywordsEsophagogastric varices Variceal hemorrhage Red color sign Portal pressure Variceal wall tension